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Unipolar DepressionPhase 2ImproveNCT02822443

Improve: Integrating Emotion Focused Components Into Psychological Therapy

A Phase 2 study testing Psychological therapy (PT) as TAU with integrated emotion focused components (TAU - EFT) and Psychological therapy (PT) as TAU with focus on self-regulation (TAU - SR) in people with Unipolar Depression and Anxiety Disorder, run by University of Bern at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary purpose of this study is to compare the efficacy of two treatment-as-usual (TAU) conditions: TAU with integration of emotion focused components (EFT) and TAU with focus on self-regulation (SR). Especially the long-term efficacy is evaluated with a focus on differential effects. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Psychological therapy (PT) as TAU with integrated emotion focused components (TAU - EFT) and Psychological therapy (PT) as TAU with focus on self-regulation (TAU - SR)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
104 participants
Where
1 siteSwitzerland
Study dates
Apr 2015to Aug 2019
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Major Depressive Disorder, Anxiety Disorder or Adjustment Disorder according to DSM-IV as main diagnosis
  • Minimum age of 18 years
  • Mastery of the German language for being able to undergo a psychotherapy in German
  • Written informed consent to participate voluntary in the study

Who cannot join

  • Acute suicidality or immediate threats of self-harm
  • Diagnosis or history of a psychotic disorder
  • Mood incongruent psychotic symptoms
  • Bipolar disorder
  • Comorbid chronic organic disorder
  • Substance use disorder as a main diagnosis
  • Indication for a residential treatment

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • University of Bern

    Bern

Other trials in Switzerland

About this study

Official title: The Impact of Integrating Emotion Focused Components Into Psychological Therapy

The primary purpose of this study is to compare the efficacy of two treatment-as-usual (TAU) conditions: TAU with integration of emotion focused components (EFT) and TAU with focus on self-regulation (SR). Especially the long-term efficacy is evaluated with a focus on differential effects. Moreover, the mechanisms of change of both conditions are investigated.

Read the detailed description

Background:

"General Psychotherapy" postulates an ongoing process of including all interventions and concepts relevant for a domain, be they from other approaches to psychotherapy or concepts from basic science. "Psychological Therapy" (PT) is a therapeutic approach largely corresponding to the ideas of General Psychotherapy. It draws mainly on empirically validated interventions from Cognitive Behavior Therapy (CBT) and is based on concepts with a strong basis in academic psychology and neighboring fields. PT is based on explicit individual case conceptualization, reference to general therapeutic factors, and an explicit prescriptive concept for building and maintaining the therapeutic relationship. However the range of emotion-related interventions commonly used in PT is limited when compared with an approach like Emotion Focused Therapy (EFT). EFT appears thus as a suitable complement and enrichment to PT as commonly practiced. However, effects of integrating EFT-based interventions in a way that is close to common integrative practice have not yet been studied.

Objective:

To compare the efficacy of two treatment-as-usual (TAU) conditions: TAU with integration of EFT components and TAU with focus on self-regulation (SR).

Methods:

In Switzerland, a randomized-controlled trail will be carried out in secondary care, comparing the efficacy of TAU - EFT and TAU - SR for adults with major depressive disorder, anxiety disorder or adjustment disorder. Respondents will be followed until 36 months after end of therapy (measures will be taken at baseline, after 8 and after 16 weeks, at the end of therapy after 25 weeks, 6 months, 12 months and 36 months follow-up).

Being tested
Psychological therapy (PT) as TAU with integrated emotion focused components (TAU - EFT), Psychological therapy (PT) as TAU with focus on self-regulation (TAU - SR)
Medical subject headings
Depressive Disorder, Anxiety Disorders, Adjustment Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Psychological therapy (PT) as TAU with integrated emotion focused components (TAU - EFT)Behavioural

    25 (+/- 3) weekly sessions and up to three booster sessions of face-to-face outpatient psychotherapy; psychological therapy with focus on emotion-focused interventions.

  • Psychological therapy (PT) as TAU with focus on self-regulation (TAU - SR)Behavioural

    25 (+/- 3) weekly sessions and up to three booster sessions of face-to-face outpatient psychotherapy; psychological therapy with focus on self-regulation without emotion-focused interventions

Study groups in NCT02822443
Study groupRoleWhat they receive
TAU - EFTExperimentalThis arm integrates emotion focused components (EFT; Greenberg, 2010) into psychological therapy (PT) as treatment-as-usual (TAU), aiming at clarifying and transforming maladaptive emotions. 25 (+/- 3) weekly sessions and up to three booster sessions of face-to-face outpatient psychotherapy; psychological therapy with focus on emotion-focused interventions.
Receives: Behavioral: Psychological therapy (PT) as TAU with integrated emotion focused components (TAU - EFT)
TAU - SRExperimentalThis arm focuses on the training of self-regulation strategies (SR; Carver \& Scheier, 2000) in the context of psychological therapy (PT) as treatment-as-usual (TAU). 25 (+/- 3) weekly sessions and up to three booster sessions of face-to-face outpatient psychotherapy; psychological therapy with focus on self-regulation without emotion-focused interventions.
Receives: Behavioral: Psychological therapy (PT) as TAU with focus on self-regulation (TAU - SR)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline in symptom impairment measured by the Brief Symptom Inventory (BSI; Franke, 2000)

    Measured: After 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  2. Change from baseline in depressive symptoms measured by the Beck Depression Inventory (BDI-II; Hautzinger et al., 2006)

    Measured: After 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  3. Change from baseline in anxiety symptoms measured by the Beck Anxiety Inventory (BAI; Ehlers & Margraf, 2007)

    Measured: After 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

Secondary outcomes (26)
  1. Severity of panic disorder and agoraphobia with the Panic and Agoraphobia Scale (PAS; Bandelow, 1997)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  2. Severity of social phobia measured by the Social Phobia Scale SPS; Stangier et al., 1999)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  3. Severity of social interaction anxiety measured by the Social Interaction Anxiety Scale (SIAS; Stangier et al., 1999)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  4. Severity of anxiety symptoms measured by the Questionnaire for General Anxiety Disorder (GAD-7; Spitzer et al., 2006)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  5. Psychological well-being measured with the WHO Well-Being Index (WHO-5; Henkel et al., 2004)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  6. Health-related quality of life measured with the Short Form Healthy Survey (SF-12; Gandek et al., 1998)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  7. Motivational schemata measured by the Questionnaire for Analysis of Motivational Schemata (FAMOS; grosse Holtforth & Grawe, 2000)

    Measured: Baseline, end of therapy after 25 weeks

  8. Motivational incongruence measured by the Incongruence Questionnaire (K-INK; grosse Holtforth et al., 2003)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  9. Interpersonal problems measured by the Inventory of Interpersonal Problems (IIP-32; Thomas et al., 2011)

    Measured: Baseline, after 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  10. Personality structure measured by the Operationalized Psychodynamic Diagnosis Structure Questionnaire (OPD-SFK; Ehrenthal et al., 2012)

    Measured: Baseline, end of therapy after 25 weeks

  11. Personality traits measured by the Inventory of Personality Organization (IPO-16; Zimmermann et al., 2013)

    Measured: Baseline

  12. Ambivalence over emotional expressiveness measured by the Ambivalence over the Expression of Emotion Scale (AVEX; Trachsel et al., 2010)

    Measured: Baseline, end of therapy after 25 weeks

  13. Emotional competency measured by the Questionnaire for the self-assessment of emotional competencies (SEK-27; Berking & Znoj, 2008)

    Measured: Baseline, end of therapy after 25 weeks

  14. Generalized expectancies for negative mood regulation measured by the Negative Mood Regulation Scale (NMR-SF; Pfeiffer et al., 2013)

    Measured: Baseline, end of therapy after 25 weeks

  15. Psychological flexibility measured by the Acceptance and Action Questionnaire (Fragebogen zu Akzeptanz und Handeln; FAH-II; Gloster et al., 2013)

    Measured: Baseline, end of therapy after 25 weeks

  16. General self-efficacy measured by the General Self-Efficacy Scale (SWE; Schwarzer & Jerusalem, 1999)

    Measured: Baseline, end of therapy after 25 weeks

  17. Therapy evaluation and outcome expectancies measured by the Patient Questionnaire on Therapy Expectation and Evaluation (PATHEV; Schulte, 2005)

    Measured: Baseline

  18. Social desirability measured by the Balanced Inventory of Desirable Responding (BIDR-K; Winkler et al., 2006)

    Measured: Baseline

  19. Client satisfaction measured by the Brief Global Measure of Client Satisfaction (ZUF-8; Schmidt & Wittmann, 2002)

    Measured: After 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  20. External assessment of interpersonal personality measured by the Impact Message Inventory (IMI-R; Caspar et al. 2002)

    Measured: Baseline, end of therapy after 25 weeks

  21. External assessment of resources measured by the Bernese Inventory of Resources (REF-F and REF-T; Tröske, 2000)

    Measured: Baseline, end of therapy after 25 weeks

  22. External assessment of positive interpersonal qualities measured by the Inventory of Interpersonal Strengths (IIS; Hatcher & Rogers, 2012)

    Measured: Baseline, end of therapy after 25 weeks

  23. Goal attainment measured by the Goal Attainment Scaling (GAS; Kirusek, 1994)

    Measured: After 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up

  24. Regular quality monitoring with the Bern Post Session Report, Patient and Therapist Version (BPSR-P/T; Flückiger et al. 2010)

    Measured: Weekly until 25 weeks

  25. Symptom impairment measured by the Symptom Checklist (SCL-9; Bogerts et al., 2001)

    Measured: Weekly until 25 weeks

  26. Implicit motives measured by the Picture-Story-Exercise - Online Version (PSE-O: Bernecker & Jobst, 2013)

    Measured: Baseline, end of therapy after 25 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Jul 2016 (estimated)
  2. Study startApr 2015
  3. Primary completionJul 2018
  4. Study completionAug 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
104 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02822443
Sponsor's protocol ID
SNF100019_159425 /1
Acronym
Improve
Status last verified
Sep 2019
First submitted
22 Jun 2016
Last updated
10 Sep 2019
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Babl A, Grosse Holtforth M, Heer S, Lin M, Stahli A, Holstein D, Belz M, Egenolf Y, Frischknecht E, Ramseyer F, Regli D, Schmied E, Fluckiger C, Brodbeck J, Berger T, Caspar F. Psychotherapy integration under scrutiny: investigating the impact of integrating emotion-focused components into a CBT-based approach: a study protocol of a randomized controlled trial. BMC Psychiatry. 2016 Nov 24;16(1):423. doi: 10.1186/s12888-016-1136-7.

    PubMed 27881113

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Psychological therapy (PT) as TAU with integrated emotion focused components (TAU - EFT) and Psychological therapy (PT) as TAU with focus on self-regulation (TAU - SR) in people with Unipolar Depression and Anxiety Disorder, run by University of Bern at 1 site in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline in symptom impairment measured by the Brief Symptom Inventory (BSI; Franke, 2000) (time frame: After 8 weeks, after 16 weeks, end of therapy after 25 weeks, 6 months follow-up, 12 months follow-up and 36 months follow-up). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02822443, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2019.

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